Is your body turning yellow? Let's learn about the bilirubin test.

Have you ever felt like your skin or the whites of your eyes have turned yellow? Or have you ever heard someone say, "The baby is a little yellow, we need to turn on the lights" when you go to see a newborn baby? We call this condition jaundice. The main reason for this is that the 'bilirubin' in our body increases. So, today we will talk about what this bilirubin test is and why it is done.

What exactly is bilirubin?

Simply put, bilirubin is a yellow-orange pigment that is produced when our red blood cells break down. Think of the red blood cells in our bodies as little workers. They work for a while and then 'retire', which means they die. This waste product is called bilirubin.

What normally happens is that our liver takes the bilirubin in the blood, changes its chemical nature, and removes it from the body. Most of it is excreted in the feces as bile, and a small amount is excreted in the urine.

However, if your bilirubin level is higher than normal, it means that either your red blood cells are breaking down faster than normal, or your liver is not able to properly clean this bilirubin and get it out of your body. Sometimes this can happen if there is a blockage in the pathway that carries bilirubin from the liver to the stool.

Why do we need to do this bilirubin test?

In both adults and children, doctors use this test to look for and monitor diseases of the liver and bile ducts. For example, it can help diagnose conditions like cirrhosis, hepatitis, or gallstones.

In addition, this test is also important to confirm the presence of certain types of anemia, especially hemolytic anemia, in which red blood cells are destroyed faster than they are produced.

Jaundice, a yellowing of the skin and eyes, occurs when bilirubin levels become too high. This condition is very common among newborn babies. Doctors will determine whether treatment is needed based on the baby's age, bilirubin level, and type.

How is this test done?

Bilirubin levels can be measured in both your urine and blood. A urine test is usually done to check for bilirubin. If your urine shows bilirubin, your doctor will then order a blood test to determine the exact amount in your blood.

This is usually done with a blood test. A nurse or lab technician will take a small amount of blood from a vein in your arm using a small needle. For newborns, blood is usually taken by making a small puncture in the heel of the baby.

Especially for young babies and those who are afraid of needles, there is sometimes a test that is done without inserting a needle. It is called transcutaneous bilirubin measurement . A small device is placed on the baby's chest or forehead and a light is shone through it. It can measure bilirubin levels without taking blood.

Who should take this test?

There are several situations in which your doctor may order this test. See the table below.

How should I prepare before the test?

Typically, you will be advised not to eat or drink anything for 4 hours before the test . Also, some medications you are taking can affect the results of this test. Therefore, it is very important to tell your doctor about all medications you are taking, even vitamins.

• Medications that can increase bilirubin levels include: some antibiotics, antimalarials, morphine, oral contraceptives, and some steroids.
• Drugs that can lower bilirubin levels: barbiturates, caffeine, penicillin, and high doses of salicylates.

What do the results say?

A bilirubin test measures your total bilirubin level. We can also determine the levels of the two main types separately.

1. Unconjugated bilirubin: Also called "indirect." This is the 'raw' bilirubin that is produced when red blood cells break down. It travels through the bloodstream to the liver.

2. Conjugated bilirubin: This is also called "direct." After it reaches the liver, the 'raw' bilirubin is chemically modified and made into a form that can be excreted from the body. That 'purified' bilirubin is what we call conjugated bilirubin.

Normal bilirubin levels

| Person/Type | Normal Level (mg/dl) |

| ------------------- | ------------------------------------------ |

| Adults (over 18 years) | Up to 1.2 mg/dl (Total Bilirubin) |

| Children (under 18 years) | Up to 1.0 mg/dl (Total Bilirubin) |

| Newborns | Up to 12 mg/dl (Total Bilirubin) - sometimes even more |

| Conjugated (Direct) | Should be less than 0.3 mg/dl |

What if the bilirubin level is high? (High Bilirubin)

If an adult's bilirubin level is higher than 2.0 mg/dl, it may be a sign of jaundice. If a newborn baby's level is higher than 15 mg/dl, doctors will start treatment.

Causes of increased bilirubin:

• Anemia
• Cirrhosis
• A reaction to a blood transfusion
• Gilbert syndrome - This is a common, hereditary condition caused by a deficiency of an enzyme that breaks down bilirubin.
• Viral hepatitis
• Liver disease caused by excessive alcohol consumption
• Gallstones
• Strenuous exercise, such as running a marathon

Causes of increased bilirubin in newborn babies:

• Blood type incompatibility between mother and baby
• Lack of oxygen at birth
• A hereditary infection
• A disease that affects the liver

What if the bilirubin level is low? (Low Bilirubin)

Low bilirubin levels are usually not considered a major problem. They can be caused by caffeine or certain medications. Rarely, they can also be associated with certain autoimmune diseases.

It usually takes a few hours or a day to get the test results. When you get your results, your doctor will explain what they mean and what to do next.

Bilirubin, Bilirubin Test, Jaundice, Liver, Liver disease, Blood tests, Yellow fever